how to use remifentanil in general anaesthesia - PowerPoint PPT Presentation

How to use remifentanil in general anaesthesia. ULT/SLK/05/19768/2 August 2005 . How to use remifentanil in general anaesthesia. Properties of remifentanil Intra-operative control Recovery Reconstitution Dosing protocol for general anaesthesia

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The dosage and timing of administration of the alternative long-acting analgesic agent should be considered to allow therapeutic effects to become established1

Minkowitz et al. achieved adequate post-operative pain management with a 150 or 200μg/kg bolus of morphine sulphate administered 30 minutes before the end of surgery2

Muñoz et al. used 150μg/kg morphine and showed a reduction in the number of patients requiring morphine in the post-anaesthesia care unit, when morphine had been given more than 40 minutes before the end of surgery3

Due to the very rapid offset of action of remifentanil, post-operative analgesia must be planned well in advance of remifentanil discontinuation

Care should be taken to avoid inadvertent administration of remifentanil remaining in IV lines and cannulae

Muscle rigidity induced by remifentanil must be treated in the context of the patient's clinical condition with appropriate supporting measures including ventilatory support.

Remifentanil should only be used in areas where facilities for monitoring and dealing with respiratory depression are available

Hypotension and bradycardia may be managed by reducing the rate of infusion of remifentanil or the dose of concurrent anaesthetics or by using IV fluids, vasopressor or anticholinergic agents as appropriate